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claims for this procedure

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A 74 year old obese female with tespiratory failure requires mechanical ventilation. During surgery, two procedures will be performed. First, due to her chronic respiratory disease, it is assumed that she will require long-term ventilatory support, necessitating tracheostomy placement, Second, due to the obesity and excessive cervical adipose tissue and skin, lipectomy and skin resection are also necessary. What CPT and ICD 9-CM codes should be inclided in the claims for this procedure?.

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the trach is pretty straightforward
ICD-9 is resp failure 518.81 CPT for trach is 31600

for the lipectomy, ...

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